Hip replacement is a significant procedure that many individuals face, often due to osteoarthritis or other joint issues that severely limit daily activities. As a personal trainer, I have had the privilege of working with a client preparing for hip replacement surgery. Throughout our training sessions, I’ve gained valuable insights into how to support and prepare clients for such surgeries, focusing on mobility, stability, and functional movement. In this post, I’ll share what I’ve learned from working with my client and how these lessons can be applied to help others in similar situations.
Why Do People Need Hip Replacements?
Hip replacements are often necessitated by conditions like osteoarthritis, which wears down the joint, causing pain and limited range of motion. In my client’s case, osteoarthritis in her right hip made everyday activities, such as walking or bending, increasingly difficult. The lack of mobility and persistent pain led to the decision for hip replacement surgery.
Initial Assessment: Identifying Limitations
Before diving into a pre-surgery training plan, the first step was to assess her overall movement patterns and limitations. The right hip was clearly restricted, particularly in extension. This restriction forced other joints, like the lumbar spine, to compensate during movements, leading to further imbalances.
We tested various lower-body exercises, such as squats, lunges, step-ups, single-leg Romanian deadlifts (RDLs), and deadlifts. Movements like squats and deadlifts proved especially challenging because they required compensation from the lumbar spine to complete the range of motion.
Prioritizing Functional Movements Over Heavy Lifting
Given the challenges with range of motion and compensation patterns, our focus shifted toward functional movements rather than lifting heavy weights. Lunges and step-ups were the most effective exercises to maintain strength and mobility without putting excessive strain on the hip or lower back.
Squats were still incorporated into the routine but at a shallow depth to avoid further irritation. Repetitive movements with added weight were avoided to reduce the risk of low-back issues, especially as her spine tended to tilt laterally during squats.
Stability and Strengthening the Core and Hips
Stability training became a key focus, particularly in the hips and core. Exercises like half-kneeling and split stance movements helped improve balance and stability, targeting the hip and abdominal region to build strength around the arthritic hip. Ankle stability was also included as it plays an important role in maintaining overall balance and preventing falls.
Flexibility and Mobility for the Hip Flexors
Incorporating flexibility work, especially for the hip flexors, was critical in our sessions. We dedicated the last five minutes of each workout to stretching the right hip flexor. This was vital preparation for surgery since tight hip flexors can exacerbate mobility issues and hinder post-surgical recovery.
The basic idea was to stretch the hip flexors while simultaneously strengthening the posterior chain—hamstrings and glutes—to create balance in the lower body.
Posture and Movement Patterns: Addressing the Root Cause
An essential part of our training was correcting posture and movement patterns. If poor movement mechanics contributed to the original development of osteoarthritis, the hip replacement would only serve as a temporary solution. By reinforcing proper posture and movement, we aimed to prevent future issues and ensure long-term success after surgery. Addressing these underlying issues is crucial to preventing recurring joint problems and achieving better outcomes post-surgery.
Conclusion
Training a client before hip replacement surgery involves much more than just building strength. It’s about improving mobility, enhancing stability, and addressing posture and movement patterns to prevent further complications. By focusing on functional movements, stretching, and stability, we can better prepare clients for surgery and ensure a smoother recovery process. Working with clients facing hip replacements has deepened my understanding of how tailored, thoughtful training can make a significant difference in their long-term health and quality of life.
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